Eight in 10 doctors are at high or very high risk of “burnout”, driven mostly by exhaustion rather than feeling disengaged with their roles, the British Medical Association (BMA) has warned.
The BMA found that more than a quarter (27%) of doctors and medical students had been diagnosed with a mental health condition at some point in their lives – 90% of whom said their current working, training or studying environment had been a contributory factor.
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Those who were managing a condition were most likely to report feeling less able to take on additional responsibilities or hours and were more likely to worry about making mistakes, the survey of 4,300 medical professionals and students found.
Professor Dinesh Bhugra CBE, BMA president, said: “The findings speak for themselves. With four in 10 of the respondents surveyed currently suffering from depression, anxiety, burnout, stress, emotional distress or another mental health condition, and an overwhelming eight in ten of those surveyed at high risk of burnout, the enormous demands being placed on doctors have come at a worrying price.
“While there is no denying that being a doctor is a challenging and demanding role, too often the line of what can be considered routine pressures of the job has most definitely been crossed and the consequence is a workforce that has been pushed to literal breaking point.
“As the people who are entrusted with caring for the health of others, doctors often feel particularly vulnerable or unable to come forward and seek help for fear of judgement and or any perceived ramification a declaration of poor mental health may have on their prospective career.”
Professor Bhugra noted that there needed to be a cultural shift to encourage doctors to seek help if they needed it, as well as addressing the pressures on working environment such as long hours, unmanageable workloads and rota gaps.
“A system that fails to support and protect the health of its own workforce will only flounder and this is as clear a call to action if ever there was one,” he said.
Deep aversion to ‘failing’
One anaesthetist trainee, Dr Thomas Kitchen, told the BMA that working as a junior doctor had significantly affected his mental health.
“I feel that this is made worse by the broad stigma around disclosure of mental health disorders, suicide, substance misuse and vulnerability within our professional culture. Given their backgrounds and exposure to certain education systems and culture, many doctors and medical students can often feel a deep aversion to ‘failing’ and perhaps can’t even perceive what failure would really mean or look like,” he said.
“Sadly, but inevitably in this job, particularly given the current pressures, not everything goes the way you would like or plan, even when you have done everything right. How we manage ourselves in the face of our perceived failings can add a unique pressure on top of already challenging situations. We need to be kinder to ourselves.”
One in three said they regularly or occasionally used alcohol or drugs as a way to cope with a mental health condition, the BMA report – Caring for the mental health of the medical workforce – claimed. Male and older doctors were more likely to regularly to use these as a coping mechanism, as well as self-prescribing medication.
Four in 10 said they suffered from a broad range of psychological or emotional conditions, although doctors working 51 or more hours per week were most likely to say they were currently managing a condition.
Almost half of respondents with depression, anxiety, burnout, stress, emotional distress or a mental health condition had been offered support by their employer or medical school, but many felt this support did not meet their needs. Nine per cent said they asked for support, but were not offered it by their employer or medical school.
Last year NHS England extended the mental health support it offered to a further 111,000 doctors. Previously, support had only been offered to GPs and trainee doctors.
`All talk and no action as usual. Plenty of “surveys” and “research” and “studies”. We all know what the problems are. If you want a hole digging, you need a man with a spade – NOT a director of digging services, a spade procurement department, a holes steering committee and a performance and appraisal system for the one man digging. When is the BMA going to actually DO something rather than tutting and wringing its stupid useless hands.` [anon]